Kids Health Info

Autism Spectrum Disorder

  • Autism Spectrum Disorder (ASD) is a term used for a group of conditions which include Autism, Asperger's Syndrome, Pervasive Developmental Disorder (PDD) and Pervasive Developmental Disorder - Not Otherwise Specified (PDDNOS). Children with ASD have problems with their communication, social interactions, imagination and play. ASD is a life-long disorder.

    It is important to remember that no two children with ASD are exactly the same, although they may have similar problems.  That is why the disorder is called a 'spectrum'.

    If you are concerned about these aspects of your child's behaviour, please see your family doctor and ask for a referral to a specialist paediatrician or psychologist. Do not try to make a diagnosis yourself.

    Signs and symptoms

    Children with ASD tend to have difficulties in three main areas:

    1. Social interaction

    A child with ASD may have many unusual ways of interacting socially. They may only interact with others when they need to or they might actively talk with others but only about their own special interests. Common ways of describing the interactions of children with ASD include seeming at times 'aloof', 'passive', 'active but odd' or 'overly formal and stilted'.


    2. Communication

    Many children with ASD have poor communication skills or focus their communication towards objects rather than people. Children with more severe ASD do not speak. There are many children with ASD who have normal language skills but will have problems with social language. Their conversations may be one-sided or they may talk a lot or repeat certain words over and over, such as "me" or "you". This is called 'echolalia'.  

    Most children with ASD have difficulties with 'non-verbal communication', such as making sustained eye contact, reading body language and other non-verbal "cues" such as understanding or expressing emotions through tone of voice and facial expressions.


    3. Imagination and Play 

    Children with ASD often lack creativity and imaginative play. They may prefer using their senses to explore toys, for example smelling, tasting or staring at the toys rather than playing with them. Some children prefer repetitive or obsessive actions such as lining toys up in a long line or continuously spinning a car wheel. Other children become good at copying the way other children play or events such as movie scenes.

    Higher-functioning children with ASD (such as children with Asperger's syndrome) can become intensely interested in one topic, often to the exclusion of other activities or interests.

    Intellectual ability

    One of the main factors that affects how a child with ASD behaves and functions is their intellectual ability (i.e. IQ). Children with ASD can range from being severely disabled through to highly intelligent. About one child in four with ASD has an IQ in the normal range or above, but three out of four children with ASD will have some intellectual disability. The child's level of ability is often uneven, with areas of strength and weakness. 

    Associated problems

    As well as the previously described impairments, many children with ASD can have other difficulties which include:   

    • Repetitive movements (such as flapping of their hands).
    • Being more or less sensitive than normal to smells, sounds, sights or touch.
    • Restricted eating patterns.
    • Sleeping problems.
    • Anxiety.
    • Behaviour problems.                     
    • Emotional difficulties.
    • Learning difficulties.                               
    • Attention difficulties.
    • Difficulties with planning and organising.

    Children with ASD may have other medical conditions such as epilepsy, nutritional deficiencies or rare disorders including fragile X and tuberous sclerosis. 

    Causes

    Research suggests that ASD is a genetic condition, but the exact gene thought to cause the disorder has not yet been identified. Research continues, with the aim of finding the cause and discovering more treatment options. 

    Diagnosis

    The diagnosis of ASD requires three independent specialist assessments. A paediatrician, psychologist and speech pathologist need to assess your child. As features vary so much between children, there is no single or simple test for ASD. If you are concerned about any aspect of your child's behaviour, please talk to your family doctor and ask for a referral to a specialist paediatrician or psychologist. 

    Treatment

    Treatment varies according to the needs of each child and the nature of their impairment/s and may include:

    • Speech therapy: most children with ASD have communication difficulties and benefit greatly from seeing a speech therapist to help them improve their language and social skills in connecting with others through conversation. Visit www.speechpathologyprivate.com for more information.  
    • Medication: may be helpful in some specific situations.   
    • Behaviour  therapy: a psychologist may help identify triggers for behavioural outbursts and help the family develop ways to avoid and/or manage these issues.
    • Social skills development: a therapist called an 'Applied Behaviour Analysis (ABA) therapist' works one-on-one with children to help them 'learn how to learn' and to develop social and communication skills. Visit www.abia.net.au for more information. 
    • Occupational therapy: occupational therapists can help children who are hyper-sensitive to hearing, visual input or touch.
    • Environmental changes: children with ASD prefer a structured and predictable environment and routine. Visual aids such as picture cards (e.g. a picture of a bed that a child can point to) can be very helpful to improve children's understanding and communication and therefore reduce their stress.
    • Special education settings: there are a number of early intervention programs and specialist schools.  Visit www.education.vic.gov.au for more information.
    • Early intervention: the team or specialist will help to develop an action plan for the family that can include information resources, parent training, strategies for family support and an action plan for the child.

    Key points to remember

    • If you are concerned about your child's behaviour, please see your family doctor and ask for a referral to a specialist psychologist or paediatrician. Do not try to make a diagnosis yourself.
    • A child with ASD usually has difficulties in three main areas:
      • social interaction and communication
      • delayed language development
      • impaired imagination and play.
    • A child with ASD may also have other difficulties.
    • No two children with ASD show exactly the same signs and symptoms and these may change over time. Because the symptoms can vary so much, there is no test for ASD.
    • Treatment varies for each child and family and usually changes over time.

    For more information

    Visit the following websites for more information:

     

    Developed by RCH Quality and Improvement, with thanks to RCH psychologists, paediatricians and general practitioners for their significant input. First published August 2008. Updated May 2013.



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This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.